Guidelines for specialized nutritional and metabolic support in the critically-ill patient. Update. Consensus SEMICYUC-SENPE: Obese patient

As a response to metabolic stress, obese critically-ill patients have the same risk of nutritional deficiency as the non-obese and can develop protein-energy malnutrition with accelerated loss of muscle mass. The primary aim of nutritional support in these patients should be to minimize loss of lean mass and accurately evaluate energy expenditure. However, routinely used formulae can overestimate calorie requirements if the patient's actual weight is used. Consequently, the use of adjusted or ideal weight is recommended with these formulae, although indirect calorimetry is the method of choice. Controversy surrounds the question of whether a strict nutritional support criterion, adjusted to the patient's requirements, should be applied or whether a certain degree of hyponutrition should be allowed. Current evidence suggested that hypocaloric nutrition can improve results, partly due to a lower rate of infectious complications and better control of hyperglycemia. Therefore, hypocaloric and hyperproteic nutrition, whether enteral or parenteral, should be standard practice in the nutritional support of critically-ill obese patients when not contraindicated. Widely accepted recommendations consist of no more than 60-70% of requirements or administration of 11-14 kcal/kg current body weight/day or 22-25 kcal/kg ideal weight/day, with 2-2.5 g/kg ideal weight/day of proteins. In a broad sense, hypocaloric-hyperprotein regimens can be considered specific to obese critically-ill patients, although the complications related to comorbidities in these patients may require other therapeutic possibilities to be considered, with specific nutrients for hyperglycemia, acute respiratory distress syndrome (ARDS) and sepsis. However, there are no prospective randomized trials with this type of nutrition in this specific population subgroup and the available data are drawn from the general population of critically-ill patients. Consequently, caution should be exercised when interpreting these data.

Vitamin C requirements in parenteral nutrition.

Some biochemical functions of vitamin C make it an essential component of parenteral nutrition (PN) and an important therapeutic supplement in other acute conditions. Ascorbic acid is a strong aqueous antioxidant and is a cofactor for several enzymes. The average body pool of vitamin C is 1.5 g, of which 3%-4% (40-60 mg) is used daily. Steady state is maintained with 60 mg/d in nonsmokers and 140 mg/d in smokers. Shocked surgical, trauma, and septic patients have a drastic reduction of circulating plasma ascorbate concentrations. These low concentrations require 3-g doses/d to restore normal plasma ascorbate concentrations, questioning the recommended PN dose of 100 mg/d. Determination of intravenous requirements is usually based on plasma concentrations, which are altered during the inflammatory response. There is no clear indicator of deficiency: serum or plasma ascorbate concentrations <0.3 mg/dL (20 micromol/L) indicates inadequate vitamin C status. On the basis of available pharmacokinetic data the 100 mg/d dose for patients receiving home PN and 200 mg/d for stable adult patients receiving PN are adequate, but requirements have been shown to be higher in perioperative, trauma, burn, and critically ill patients, paralleling oxidative stress. One recommendation cannot fit all categories of patients. Large vitamin C supplements may be considered in severe critical illness, major trauma, and burns because of increased requirements resulting from oxidative stress and wound healing. Future research should distinguish therapeutic use of high-dose ascorbic acid antioxidant therapy from nutritional PN requirements.

Dietary fiber, energy intake and nutritional status during the treatment of children with chronic constipation

The present prospective study was carried out to determine dietary fiber and energy intake and nutritional status of children during the treatment of chronic constipation. Twenty-five patients aged 2 to 12 years with chronic constipation were submitted to clinical evaluation, assessment of dietary patterns, and anthropometry before and after 45 and 90 days of treatment. The treatment of chronic constipation included rectal disimpaction, ingestion of mineral oil and diet therapy. The standardized diet prescribed consisted of regular food without a fiber supplement and met the nutrient requirements according to the recommended daily allowance. The fiber content was 9.0 to 11.9 g for patients aged less than 6 years and 12.0 to 18.0 g for patients older than 6 years. Sixteen patients completed the 90-day follow-up and all presented clinical improvement. The anthropometric variables did not change, except midarm circumference and triceps skinfold thickness which were significantly increased. Statistically significant increases were also found in percent calorie intake adequacy in terms of recommended daily allowance (55.5 to 76.5% on day 45 and to 68.5% on day 90; P = 0.047). Percent adequacy of minimum recommended daily intake of dietary fiber (age + 5 g) increased during treatment (from 46.8 to 52.8% on day 45 and to 56.3% on day 90; P = 0.009). Food and dietary fiber intake and triceps skinfold thickness increased during follow-up. We conclude that the therapeutic program provided a good clinical outcome.

Process Optimization for Mass Production of Marine Yeast Candida sp. S 27 and its Nutritional Characterization

The main source of protein for human and animal consumption is from the agricultural sector, where the production is vulnerable to diseases, fluctuations in climatic conditions and deteriorating hydrological conditions due to water pollution. Therefore Single Cell Protein (SCP) production has evolved as an excellent alternative. Among all sources of microbial protein, yeast has attained global acceptability and has been preferred for SCP production. The screening and evaluation of nutritional and other culture variables of microorganisms are very important in the development of a bioprocess for SCP production. The application of statistical experimental design in bioprocess development can result in improved product yields, reduced process variability, closer confirmation of the output response to target requirements and reduced development time and overall cost.The present work was undertaken to develop a bioprocess technology for the mass production of a marine yeast, Candida sp.S27. Yeasts isolated from the offshore waters of the South west coast of India and maintained in the Microbiology Laboratory were subjected to various tests for the selection of a potent strain for biomass production. The selected marine yeast was identified based on ITS sequencing. Biochemical/nutritional characterization of Candida sp.S27 was carried out. Using Response Surface Methodology (RSM) the process parameters (pH, temperature and salinity) were optimized. For mass production of yeast biomass, a chemically defined medium (Barnett and Ingram, 1955) and a crude medium (Molasses-Yeast extract) were optimized using RSM. Scale up of biomass production was done in a Bench top Fermenter using these two optimized media. Comparative efficacy of the defined and crude media were estimated besides nutritional evaluation of the biomass developed using these two optimized media.

Use of L-Proline and ATP Production by Trypanosoma cruzi Metacyclic Forms as Requirements for Host Cell Invasion

The process of host cell invasion by Trypanosoma cruzi depends on parasite energy. What source of energy is used for that event is not known. To address this and other questions related to T. cruzi energy requirements and cell invasion, we analyzed metacyclic trypomastigote forms of the phylogenetically distant CL and G strains. For both strains, the nutritional stress experienced by cells starved for 24, 36, or 48 h in phosphate-buffered saline reduced the ATP content and the ability of the parasite to invade HeLa cells proportionally to the starvation time. Inhibition of ATP production by treating parasites with rotenone plus antimycin A also diminished the infectivity. Nutrient depletion did not alter the expression of gp82, the surface molecule that mediates CL strain internalization, but increased the expression of gp90, the negative regulator of cell invasion, in the G strain. When L-proline was given to metacyclic forms starved for 36 h, the ATP levels were restored to those of nonstarved controls for both strains. Glucose had no such effect, although this carbohydrate and L-proline were transported in similar fashions. Recovery of infectivity promoted by L-proline treatment of starved parasites was restricted to the CL strain. The profile of restoration of ATP content and gp82-mediated invasion capacity by L-proline treatment of starved Y-strain parasites was similar to that of the CL strain, whereas the Dm28 and Dm30 strains, whose infectivity is downregulated by gp90, behaved like the G strain. L-Proline was also found to increase the ability of the CL strain to traverse a gastric mucin layer, a property important for the establishment of T. cruzi infection by the oral route. Efficient translocation of parasites through gastric mucin toward the target epithelial cells in the stomach mucosa is an essential requirement for subsequent cell invasion. By relying on these closely associated ATP-driven processes, the metacyclic trypomastigotes effectively accomplish their internalization.

Effects of nutritional support on hospital outcome in dogs and cats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Food intake in women two years or more after bariatric surgery meets adequate intake requirements

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Reduction of the nutritional values of diets for hens through supplementation with phytase

Objetivou-se avaliar os efeitos da redução dos níveis nutricionais de dietas para poedeiras marrons em pico de postura sobre o desempenho das aves, a qualidade dos ovos e os parâmetros ósseos. No total foram avaliadas oito dietas, cada uma com cinco repetições de oito aves: 1. controle: formulada para suprir as exigências das aves; 2) controle + 0,03% ou 600 FTU; 3) 15% PB; 2.800 kcal de EM; 3,8% Ca e 0,28% Pd; 4) dieta 3 + 0,03% ou 600 FTU; 5) 14% PB; 2.750 kcal de EM; 3,4% Ca e 0,23% Pd; 6) dieta 5 + 0,03% ou 600 FTU; 7) 13% PB; 2.700 kcal de EM; 3,0% Ca e 0,18% Pd; e 8) dieta 7 + 0,03% ou 600 FTU. A redução dos níveis nutricionais prejudicou o desempenho das aves, principalmente a produção e massa de ovos, que melhorou com a inclusão de fitase nas dietas. Os parâmetros de qualidade dos ovos, no entanto, não se alteraram com a redução até o nível de 15% de PB; 2.800 kcal de EM/kg; 3,80% Ca e 0,280% Pd, o que não se repetiu nos níveis com menor densidade nutricional. Não houve efeito da redução dos níveis nutricionais sobre os parâmetros ósseos avaliados, exceto a resistência, que melhorou com a suplementação de fitase no nível de 600 FTU. A redução nos níveis nutricionais da dieta para 15% de PB, 2.800 kcal/kg de EM, 3,8% de Ca e 0,280% de Pd com a adição de 600 FTU não prejudica a produção nem a massa de ovos e melhora a saúde óssea das aves.

Modelling the maximum potential of nitrogen deposition and requirements of lysine for broilers

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Energy Requirements in Early Life Are Similar for Male and Female Goat Kids

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Influence of nutritional and management practices on productive performance and egg quality of brown egg-laying hens = Influencia de factores nutricionales y de manejo sobre la productividad y calidad del huevo en gallinas ponedoras rubias

El objetivo general de esta Tesis Doctoral fue estudiar la influencia de diversos factores nutricionales y de manejo sobre la productividad y la calidad del huevo en gallinas ponedoras comerciales rubias. Los factores estudiados fueron: 1) Cereal principal y tipo de grasa en la dieta; 2) Nivel de proteína bruta y grasa en la dieta; 3) Nivel energético de la dieta; 4) Peso vivo al inicio del período de puesta. En el experimento 1, la influencia del cereal principal en la dieta y el tipo de grasa suplementada en la dieta sobre los parámetros productivos y la calidad del huevo fue estudiado en 756 gallinas rubias de la estirpe Lohmann desde la sem 22 hasta las 54 de vida. El experimento se realizó mediante un diseño completamente al azar con 9 tratamientos ordenados factorialmente, con 3 cereales bases (maíz, trigo blando y cebada) y 3 tipos de grasa que variaban en su contenido en ácido linoléico (aceite de soja, oleína vegetal mezcla y manteca). Todas las dietas satisfacian las recomendaciones nutricionales para gallinas ponedoras rubias según el NRC (1994) y FEDNA (2008). La unidad experimental fue la jaula para todas las variables. Cada tratamiento fue replicado 4 veces, y la unidad experimental estuvo formada por 21 gallinas alojadas en grupos de 7. Las dietas fueron formuladas con un contenido nutritivo similar, excepto para el ácido linoléico, que varió en función del tipo de cereal y grasa utilizado. Así, dependiendo de la combinación de estos elementos el contenido de este ácido graso varió desde un 0.8% (dieta trigo-manteca) a un 3.4% (dieta maíz-aceite de soja). Este rango de ácido linoléico permitió estimar el nivel mínimo de este nutriente en el pienso que permite maximizar el peso del huevo. Los parámetros productivos y la calidad del huevo se controlaron cada 28 días y el peso de las aves se midió individualmente al inicio y al final del experimento con el objetivo de estudiar la variación en el peso vivo de los animales. No se observaron interacciones entre el tipo de cereal y grasa en la dieta para ninguna de las variables productivas estudiadas. Los tratamientos experimentales no afectaron a las principales variables productivas (porcentaje de puesta, peso del huevo y masa de huevo). Sin embargo, la ganancia de peso fue mayor en gallinas alimentadas con maíz o trigo que las gallinas alimentadas con cebada (243 vs. 238 vs. 202 g, respectivamente; P< 0.05). En el mismo sentido, las gallinas alimentadas con manteca obtuvieron una mayor ganancia de peso que las gallinas alimentadas con aceite de soja u oleína vegetal (251 vs. 221 vs. 210 g, respectivamente; P< 0.05). En cuanto a las variables estudiadas en relación con la calidad del huevo, ninguna de las variables estudiadas se vio afectada por el tratamiento experimental, salvo la pigmentación de la yema. Así, las gallinas alimentadas con maíz como cereal principal obtuvieron una mayor puntuación en relación con la escala de color que las gallinas alimentadas con trigo y con cebada (9.0 vs. 8.3 vs. 8.3, respectivamente; P< 0.001). La pigmentación de la yema también se vio afectada por el tipo de grasa en la dieta, así, las gallinas alimentadas con manteca obtuvieron una mayor puntuación de color en relación con la escala de color que las gallinas alimentadas con aceite de soja u oleína vegetal (8.9 vs. 8.5 vs. 8.2, respectivamente; P< 0.001). La influencia del contenido en ácido linoléico respecto al peso de huevo y masa de huevo fue mayor a medida que el contenido de dicho ácido graso se redujo en la dieta. Así, la influencia de la dieta en los radios peso de huevo/g linoléico ingerido y masa de huevo/g linoléico ingerido fue significativamente mayor a medida que el contenido en dicho ácido graso disminuyo en la dieta (P< 0.001). Los resultados del ensayo indican que las gallinas ponedoras rubias no necesitan más de un 1.0% de ácido linoléico en la dieta para maximizar la producción y el tamaño del huevo. Además, se pudo concluir que los 3 cereales y las 3 grasas utilizadas pueden sustituirse en la dieta sin ningún perjuicio productivo o referente a la calidad del huevo siempre que los requerimientos de los animales sean cubiertos. En el experimento 2, la influencia del nivel de proteína bruta y el contenido de grasa de la dieta sobre los parámetros productivos y la calidad del huevo fue estudiado en 672 gallinas ponedoras rubias de la estirpe Lohmann entre las sem 22 y 50 de vida. El experimento fue conducido mediante un diseño completamente al azar con 8 tratamientos ordenados factorialmente con 4 dietas y 2 pesos vivos distintos al inicio de puesta (1592 vs. 1860g). Tres de esas dietas diferían en el contenido de proteína bruta (16.5%, 17.5% y 18.5%) y tenían un contenido en grasa añadida de 1.8%. La cuarta dieta tenía el nivel proteico más elevado (18.5%) pero fue suplementada con 3.6% de grasa añadida en vez de 1.8%. Cada tratamiento fue replicado 4 veces y la unidad experimental consistió en 21 gallinas alojadas dentro de grupos de 7 animales en 3 jaulas contiguas. Todas las dietas fueron isocalóricas (2750 kcal EMAn/kg) y cubrieron las recomendaciones en aminoácidos para gallinas ponedoras rubias (Arg, Ile, Lys, Met, Thr, Trp, TSAA y Val) según el NRC (1994) y FEDNA (2008). Los efectos de los tratamientos sobre las variables productivas y la calidad de huevo fueron estudiados cada 28 días. La dieta no afecto a ninguna de las variables productivas estudiadas a lo largo del período productivo. Sin embargo, el peso inicial origino que las gallinas pesadas consumieran más (120.6 vs. 113.9 g; P< 0.001), obtuvieran un porcentaje de puesta mayor (92.5 vs. 89.8%; P< 0.01) y un peso del huevo mayor (64.9 vs. 62.4 g; P< 0.001) que las gallinas ligeras. El peso inicial de las gallinas no afecto al IC por kg de huevo ni a la mortalidad, sin embargo, la ganancia de peso fue mayor (289 vs. 233 g; P< 0.01) y el IC por docena de huevos fue mejor (1.52 vs. 1.57; P< 0.01) en las gallinas ligeras que en las gallinas pesadas. En cuanto a la calidad del huevo, la dieta no influyó sobre ninguna de las variables estudiadas. Los resultados del ensayo muestran que las gallinas ponedoras rubias, independientemente de su peso vivo al inicio de la puesta, no necesitan una cantidad de proteína bruta superior a 16.5% para maximizar la producción, asegurando que las dietas cubren los requerimientos en AA indispensables. Asimismo, se puedo concluir que las gallinas con un peso más elevado al inicio de puesta producen más masa de huevo que las gallinas con un peso más bajo debido a que las primeras producen más cantidad de huevos y más pesados. Sin embargo, ambos grupos de peso obtuvieron el mismo IC por kg de huevo y las gallinas más livianas en peso obtuvieron un mejor IC por docena de huevo que las pesadas. En el experimento 3 la influencia de la concentración energética sobre los parámetros productivos y la calidad del huevo fue estudiada en 520 gallinas ponedoras rubias de la estirpe Hy-Line en el período 24-59 sem de vida. Se utilizaron 8 tratamientos ordenados factorialmente con 4 dietas que variaron en el contenido energético (2650, 2750, 2850 y 2950 kcal EMAn/kg) y 2 pesos vivos distintos al inicio del período de puesta (1733 vs. 1606g). Cada tratamiento fue replicado 5 veces y la unidad experimental consistió en una jaula con 13 aves. Todas las dietas se diseñaron para que tuvieran una concentración nutritiva similar por unidad energética. Las variables productivas y de calidad de huevo se estudiaron mediante controles cada 28 días desde el inicio del experimento. No se observaron interacciones entre el nivel energético y el peso inicial del ave para ninguna de las variables estudiadas. Un incremento en la concentración energética de la dieta incrementó la producción de huevos (88.8 % vs. 91.2 % vs. 92.7 % vs. 90.5 %), masa de huevo (56.1 g/d vs. 58.1 g/d vs. 58.8 g/d vs. 58.1 g/d), y eficiencia energética (5.42 vs. 5.39 vs. 5.38 vs. 5.58 kcal EMA/g huevo) de forma lineal y cuadrática (P< 0.05) y afectó significativamente a la ganancia de peso (255 g vs. 300 g vs. 325 g vs. 359 g; P<0.05) . Sin embargo, un incremento en la concentración energética provocó un descenso lineal en el consumo de los animales (115 g vs. 114 g vs. 111 g vs. 110 g; P< 0.001) y un descenso lineal y cuadrático en el IC por kg de huevo (2.05 vs. 1.96 vs. 1.89 vs. 1.89; P< 0.01). En cuanto a la calidad del huevo, un incremento en el contenido energético de la dieta provocó una reducción en la calidad del albumen de forma lineal en forma de reducción de Unidades Haugh (88.4 vs. 87.8 vs. 86.3 vs. 84.7; P< 0.001), asimismo el incremento de energía redujo de forma lineal la proporción relativa de cáscara en el huevo (9.7 vs. 9.6 vs. 9.6 vs. 9.5; P< 0.001). Sin embargo, el incremento energético propició un incremento lineal en la pigmentación de la yema del huevo (7.4 vs. 7.4 vs. 7.6 vs. 7.9; P< 0.001). El peso vivo al inicio de la prueba afecto a las variables productivas y a la calidad del huevo. Así, los huevos procedentes de gallinas pesadas al inicio de puesta tuvieron una mayor proporción de yema (25.7 % vs. 25.3 %; P< 0.001) y menor de albumen (64.7 vs. 65.0; P< 0.01) y cáscara (9.5 vs. 9.6; P< 0.05) respecto de los huevos procedentes de gallinas ligeras. Consecuentemente, el ratio yema:albumen fue mayor (0.40 vs. 0.39; P< 0.001) para las gallinas pesadas. Según los resultados del experimento se pudo concluir que las actuales gallinas ponedoras rubias responden con incrementos en la producción y en la masa del huevo a incrementos en la concentración energética hasta un límite que se sitúa en 2850 kcal EMAn/kg. Asimismo, los resultados obtenidos entre los 2 grupos de peso al inicio de puesta demostraron que las gallinas pesadas al inicio de puesta tienen un mayor consumo y producen huevos más pesados, con el consecuente aumento de la masa del huevo respecto de gallinas más ligeras. Sin embargo, el IC por kg de huevo fue el mismo en ambos grupos de gallinas y el IC por docena de huevo fue mejor en las gallinas ligeras. Asimismo, la eficiencia energética fue mejor en las gallinas ligeras. Abstract The general aim of this PhD Thesis was to study the influence of different nutritional factors and management on the productivity and egg quality of comercial Brown laying hens. The factor studied were: 1) The effect of the main cereal and type of fat of the diet; 2) The effect of crude protein and fat content of the diet; 3) The effect of energy concentration of the diet; 4) The effect of initial body weight of the hens at the onset of lay period. In experiment 1, the influence of the main cereal and type of supplemental fat in the diet on productive performance and egg quality of the eggs was studied in 756 Lohmann brown-egg laying hens from 22 to 54 wk of age. The experiment was conducted as a completely randomized design with 9 treatments arranged factorially with 3 cereals (dented corn, soft wheat, and barley) and 3 types of fat (soy oil, acidulated vegetable soapstocks, and lard). Each treatment was replicated 4 times (21 hens per replicate). All diets were formulated according to NRC (1994) and FEDNA (2008) to have similar nutrient content except for linoleic acid that ranged from 0.8 (wheat-lard diet) to 3.4% (corn-soy bean oil) depending on the combination of cereal and fat source used. This approach will allow to estimate the minimum level of linoleic acid in the diets that maximizes egg weight. Productive performance and egg quality traits were recorded every 28 d and BW of the hens was measured individually at the beginning and at the end of the experiment. No significant interactions between main factors were detected for any of the variables studied. Egg production, egg weight, and egg mass were not affected by dietary treatment. Body weight gain was higher (243 vs. 238 vs. 202 g; P<0.05) for hens fed corn or wheat than for hens fed barley and also for hens fed lard than for hens fed soy oil or acidulated vegetable soapstocks (251 vs. 221 vs. 210 g; P< 0.05). Egg quality was not influenced by dietary treatment except for yolk color that was greater (9.0 vs. 8.3 vs. 8.3; P< 0.001) for hens fed corn than for hens fed wheat or barley and for hens fed lard than for hens fed soy oil or acidulated vegetable soapstocks (8.9 vs. 8.5 vs. 8.2, respectivamente; P< 0.001). The influence of linoleic acid on egg weight and egg mass was higher when the fatty acid was reduced in the diet. Thus, the influence of the diet in egg weight/g linoleic acid intake and egg mass/g linolec acid intake was higher when the amount of this fatty acid decreased in the diet (P< 0.001). It is concluded that brown egg laying hens do not need more than 1.0% of linoleic acid in the diet (1.16 g/hen/d) to maximize egg production and egg size. The 3 cereals and the 3 fat sources tested can replace each other in the diet provided that the linoleic acid requirements to maximize egg size are met. In experiment 2, the influence of CP and fat content of the diet on performance and egg quality traits was studied in 672 Lohmann brown egg-laying hens from 22 to 50 wk of age. The experiment was conducted as a completely randomized design with 8 treatments arranged factorially with 4 diets and 2 initial BW of the hens (1,592 vs. 1,860 g). Three of these diets differed in the CP content (16.5, 17.5, and 18.5%) and included 1.8% added fat. The fourth diet had also 18.5% CP but was supplemented with 3.6% fat instead of 1.8% fat. Each treatment was replicated 4 times and the experimental unit consisted of 21 hens allocated in groups of 7 in 3 adjacent cages. All diets were isocaloric (2,750 kcal AME/kg) and met the recommendations of brown egg-laying hens for digestible Arg, Ile, Lys, Met, Thr, Trp, TSAA, and Val. Productive performance and egg quality were recorded by replicate every 28-d. For the entire experimental period, diet did not affect any of the productive performance traits studied but the heavier hens had higher ADFI (120.6 vs. 113.9g; P< 0.001), egg production (92.5 vs. 89.8%; P< 0.01), and egg weight (64.9 vs. 62.4g; P< 0.001) than the lighter hens. Initial BW did not affect feed conversion per kilogram of eggs or hen mortality but BW gain was higher (289 vs. 233g; P< 0.01) and FCR per dozen of eggs was better (1.52 vs. 1.57; P< 0.01) for the lighter than for the heavier hens. None of the egg quality variables studied was affected by dietary treatment or initial BW of the hens. It is concluded that brown egg-laying hens, irrespective of their initial BW, do not need more than 16.5% CP to maximize egg production provided that the diet meet the requirements for key indispensable amino acids. Heavier hens produce more eggs that are larger than lighter hens but feed efficiency per kilogram of eggs is not affected. In experiment 3, the influence of AMEn concentration of the diet on productive performance and egg quality traits was studied in 520 Hy-Line brown egg-laying hens differing in initial BW from 24 to 59 wks of age. There were 8 treatments arranged factorially with 4 diets varying in energy content (2,650, 2,750, 2,850, and 2,950 kcal AMEn/kg) and 2 initial BW of the hens (1,733 vs. 1,606 g). Each treatment was replicated 5 times (13 hens per replicate) and all diets had similar nutrient content per unit of energy. No interactions between energy content of the diet and initial BW of the hens were detected for any trait. An increase in energy concentration of the diet increased (linear, P< 0.05; quadratic P< 0.05) egg production (88.8 % vs. 91.2 % vs. 92.7 % vs. 90.5 %), egg mass (56.1 g/d vs. 58.1 g/d vs. 58.8 g/d vs. 58.1 g/d), energy efficiency (5.42 vs. 5.39 vs. 5.38 vs. 5.58 kcal AMEn/g of egg), and BW gain (255 g vs. 300 g vs. 325 g vs. 359 g; P<0.05) but decreased ADFI (115 g vs. 114 g vs. 111 g vs. 110 g; P< linear, P< 0.001) and FCR per kg of eggs (2.05 vs. 1.96 vs. 1.89 vs. 1.89; linear, P< 0.01; quadratic P< 0.01). An increase in energy content of the diet reduced Haugh units (88.4 vs. 87.8 vs. 86.3 vs. 84.7; P< 0.01) and the proportion of shell in the egg (9.7 vs. 9.6 vs. 9.6 vs. 9.5; P< 0.001). Feed intake (114.6 vs. 111.1 g/hen per day), AMEn intake (321 vs. 311 kcal/hen per day), egg weight (64.2 vs. 63.0 g), and egg mass (58.5 vs. 57.0 g) were higher for the heavier than for the lighter hens (P<0.01) but FCR per kg of eggs and energy efficiency were not affected. Eggs from the heavier hens had higher proportion of yolk (25.7 % vs. 25.3 %; P< 0.001) and lower of albumen (64.7 vs. 65.0; P< 0.01) and shell (9.5 vs. 9.6; P< 0.05) than eggs from the lighter hens. Consequently, the yolk to albumen ratio was higher (0.40 vs. 0.39; P< 0.001) for the heavier hens. It is concluded that brown egg-laying hens respond with increases in egg production and egg mass, to increases in AMEn concentration of the diet up to 2,850 kcal/kg. Heavy hens had higher feed intake and produced heavier eggs and more egg mass than light hens. However, energy efficiency was better for the lighter hens.

Dietary and nutritional aspects of tooth wear

There is a general perception that the problem of tooth wear is increasing due to elements of the modern diet and due to increased retention of dentition into older age. Tooth wear encompasses erosion, abrasion and attrition of dental tissues – these often co-exist – yet in general, erosion is of more significance to the young and attrition is of more significance to the older population. Diet plays a significant role in the aetiology of tooth wear and likewise advanced tooth wear in older age may impose dietary restrictions with consequences for dietary intake and nutritional status. There is a need to increase the awareness of the disease of tooth wear and the associated nutritional problems. At present, the aetiology of tooth wear is poorly understood – especially with respect to the role of diet. Clearer information on how best to measure and monitor the incidence and prevalence is needed in order to obtain longitudinal data on trends in tooth wear and to monitor the factors that contribute to this condition. These issues will be addressed in the following presentations: 1) What is tooth wear? Aetiology, measurement and monitoring, 2) The role of diet in the aetiology of dental erosion, 3) Groups at increased risk of tooth wear: Eating disorders, ‘dieters' sportsmen and those with impairments, 4) Tooth wear in older adults: nutritional implications. In summary this symposium seeks to: 1) increase awareness of the disease of tooth wear, and its associated nutritional problems 2) increase understanding of the aetiology of tooth wear, especially the dietary role, 3) provide information on how to measure and monitor tooth wear, 4) highlight future research requirements in the area of tooth wear and diet.

Ontogeny of Solea senegalensis: digestive system and nutritional aspects

Tese de dout., Faculdade de Ciências do Mar e Ambiente, Univ. do Algarve, 2003

Nutritional screening and prevalence of hospital malnutrition risk. University Hospital of the UANL, Monterrey

Introduction: Hospital malnutrition risk has prevalence values of 20%-50%, and it is a major health problem in the health institutions worldwide. Objective: To assess the accomplishment of nutritional screening and the prevalence of hospital malnutrition risk in a University Hospital. Materials and methods: A retrospective analysis was carried out with nutritional screening, using primary data from six clinical areas obtained in the period between July 2012 and December 2013. According to previous results in Mexican health institutions and considering a mean malnutrition risk prevalence of 50%, it was calculated that a sample size of 3200 subjects was required for the assessment of valid risk values. Patients with values ≥3 on the Nutritional Risk Screening (NRS, 2002) were classiied as carriers of nutritional risk. Results: A total of 5611 patients (38% of all patients admitted) were studied. The rate of screening declined from 55% in 2012 to 31% in 2013. During the whole period, 3034 patients were classiied with risk of malnutrition (54% prevalence). Conclusions: The prevalence of hospital malnutrition risk was high. The accomplishment of the nutritional screening was deicient, and declined between 2012 and 2013. The lack of nutritional screening does not meet the vital care requirements of hospitalized patients and prevents the timely treatment of those at malnutrition risk.

Nutritional approach of inpatients with anorexia nervosa

Anorexia nervosa (AN) is the most prevalent of eating disorders in children and adolescents, and its treatment is long and complex, involving a multidisciplinary team. Nutritional rehabilitation and restoration of a healthy body weight is one of the central goals in the initial stages of inpatient treatment. However, current recommendations on initial energy requirements for these patients are inconsistent, with a clear lack of controlled studies, available scientific evidence and global consensus on the most effective and safe refeeding practices in hospitalized adolescents with anorexia nervosa (AN). Conservative refeeding recommendations have been classically established in order to prevent the refeeding syndrome. Nevertheless, various works have recently appeared advocating a higher initial caloric intake, without observing more complications or refeeding syndrome, and allowing a shorter average stay. We present our experience in the treatment of restricting AN with a conservative progressive treatment. We have obtained good results with this approach, which was well tolerated by patients, with no observing complications. As a consequence, the medical team could establish a pact about the therapeutic goals with the patients in an easier way.